Efficacy of Prophylactic use of Ciprofloxacin and Metronidazole in Mild and Moderately Severe Acute Pancreatitis

Mandal, Amrendra; Chaudhary, Sitaram; Shrestha, B; Paudel, Mukesh S; Poudyal, Nandu Silwal; Paudel, Bishnu Dutta; Bhattarai, Bikash; Ray, Sukanta; Ray, Neetu M

doi:10.31729/jnma.3130

Cited by 10 publications

(9 citation statements)

References 17 publications

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“…In national essential medicine of Nepal consists 250 medicine 75 of them are available in lower or primary health care centers some of them are available for free of cost [18,19]. In our cross-sectional study majority of antibiotics were found to be prescribed for medical prophylaxis, surgical prophylaxis or no provisional diagnosis on prescriptions were made, this trend was found in Pakistan and Nepal whereas literature after studies suggest no significant improvement for prevention of infection by using antibiotic for prophylactic purpose as article concluded that there is no meaningful improvement on pancreatitis in a study done in Nepal for prophylactic use metronidazole and ciprofloxacin [20,21]. In a randomized study in Finland on the prophylactic use of antibiotics for lactobacillus GG associated diarrhea and respiratory infection is found to be effective when this study relies on the proper diagnosis with the or screening for the causative agent but in our study, we did not found and trend of culture before prescribing antibiotic [22].…”

Section: Discussionmentioning

confidence: 88%

Comparative study of antimicrobial prescribing pattern between Nepal and Pakistan

Nadeem

Dhami

Dahal³

et al. 2020

int. arab. j antimicrob. agents

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Objective The purpose of this cross-sectional study conducted in different private and public sector hospitals of the major cities of Nepal and Pakistan was to compare and evaluate the antibiotic prescribing patterns. Methodology The data was collected based on prescriptions received from different hospitals of Lahore, Pakistan and Kathmandu, Nepal without much interaction with the patients. Results Out of a total of 272 patients, 111 (40.8%) patients from Nepal and 161 (59.19%) patients from Pakistan were prescribed with 447 antibiotics. In both countries, out of total antibiotics prescribed, 42.30% were 3rd generation cephalosporins. Also, in Pakistan and Nepal, out of all the indications, 49.2% of the antibiotics were given in medical prophylaxis. Conclusion In Pakistan, the antimicrobial prescription rate is comparatively higher than Nepal, and in both countries, there is a need of proper implementation of antibiotic prescribing guidelines for the prescription of antibiotics and the administration of antibiotics in medical prophylaxis.

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Section: Discussionmentioning

confidence: 88%

Comparative study of antimicrobial prescribing pattern between Nepal and Pakistan

Nadeem

Dhami

Dahal³

et al. 2020

int. arab. j antimicrob. agents

View full text Add to dashboard Cite

show abstract

“…12 A study published in 2018 used ciprofloxacin associated with metronidazole as antibiotic prophylaxis in acute pancreatitis and reported that there was no significant clinical improvement compared to the group that did not use antibiotic prophylaxis. 14 Recent studies have reported that the use of antibiotic prophylaxis in SAP may be associated with the development of invasive pancreatic candidiasis; in addition, they did not demonstrate any reduction in related complications. 15 Other studies have reported not only that the use of antibiotic prophylaxis has no significant clinical benefit, but also that it is associated with an increased intrahospital infection risk; therefore, the use of antibiotic treatment must be reserved only for patients with local infection or sepsis.…”

Section: Discussionmentioning

confidence: 93%

Comparison of use and non-use of prophylactic antibiotics for severe acute pancreatitis

et al. 2021

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Background: Acute pancreatitis is a frequent disease in Chile, with mortality rate of 10-30%. Prophylactic antibiotics administration has been part of severe acute pancreatitis treatment for theoretical prevention of infectious complications and mortality reduction. Yet the available evidence is controversial. The aim of the study was to demonstrate that prophylactic antibiotics do not reduce complications, need for intensive care unit bed or mortality in severe acute pancreatitis.Methods: Randomized clinical trial with simple randomization using a computational table (use or non-use of prophylactic antibiotics) of patients with severe acute pancreatitis. We define severe acute pancreatitis as APACHE II ≥8, C-reactive protein ≥150. In prophylactic antibiotics use group, ciprofloxacin and metronidazole were administered for 7 days. This preliminary report is presented with 50% of the calculated sample.Results: N=150, two randomized groups; group 1 (n=73), without prophylactic antibiotics use, and group 2 (n=77) with antibiotic prophylaxis use. Twenty-four patients (16%) required intensive care unit bed; twelve in group 1, and twelve in group 2 (p=0.53). Ten patients (6.66%) had some type of complication, one in group 1 and nine in group 2 (p=0.01). The average hospital stay was 15.7±9.0 days in group 1, and 16.8±17.9 days in group 2 (p=0.57). Mortality was four patients (2.66%), one in group 1 and three in group 2 (p=0.33).Conclusions: In this preliminary report, the prophylactic antibiotics use for severe acute pancreatitis was not shown to reduce complications, need for an intensive care unit bed or mortality.

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“…This was because infectious complication in patients with mild AP was very low, so there was no requirement to use prophylactic antibiotics. The case–control study of Mandal et al 18 . showed that the use of prophylactic antibiotics in mild and moderate AP did not improve treatment efficacy.…”

Section: Discussionmentioning

confidence: 95%

Investigation of antibiotic use in patients with acute pancreatitis in a Vietnamese hospital

et al. 2020

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Background and Aim: The aim of this study was to investigate the antibiotics used in patients with acute pancreatitis and evaluate their appropriateness. Methods: We conducted a descriptive cross-sectional study on 136 patients aged 18 years or older who were diagnosed with acute pancreatitis and admitted to a national hospital in Ho Chi Minh City from January 2017 to December 2018. Medical records of patients were reviewed for data analysis, including epidemiological characteristics, pathological characteristics, treatment methods, and treatment effectiveness. Results: There were 69.9% men and 30.1% women with a median age of 49.9 years. The most common etiologies included alcohol (21.3%), gallstones (23.6%), and hypertriglyceridemia (19.9%). The proportions of mild, moderate, and severe disease were 54.4, 39.0, and 6.6%, respectively. Antibiotics were given in 52.2% of patients. Although antibiotic prophylaxis was not recommended, 23.5% of cases used prophylactic antibiotics when there were no suspicion or evidence of infection. Conclusions: Our study suggests that it is necessary to optimize the appropriateness of antibiotic indications for patients with acute pancreatitis.

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Efficacy of Prophylactic use of Ciprofloxacin and Metronidazole in Mild and Moderately Severe Acute Pancreatitis

Cited by 10 publications

References 17 publications

Comparative study of antimicrobial prescribing pattern between Nepal and Pakistan

Comparative study of antimicrobial prescribing pattern between Nepal and Pakistan

Comparison of use and non-use of prophylactic antibiotics for severe acute pancreatitis

Investigation of antibiotic use in patients with acute pancreatitis in a Vietnamese hospital

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